Justice in Transitioning Health Systems

Although COVID-19 is no longer classified as a public health emergency of international concern (PHEIC), its aftermath continues to expose entrenched vulnerabilities in health systems worldwide. In this viewpoint, we draw on transitional justice theory to argue that health systems during and after major health emergencies often resemble states emerging from conflict—marked by systemic inequities, normalized wrongdoing, uncertainty, and institutional fragility. We propose a framework of transitional health justice (THJ) to respond to these conditions, grounded in the normative and institutional demands of the right to health. We argue that THJ and the right to health are mutually supportive: THJ gives the right to health practical pathways for redress, accountability, and reform, while the right to health anchors THJ in an established body of legal and ethical obligations. As part of this framework, we call for the creation of best practices commissions to document harms, articulate standards for just reform, and guide transformation in health systems emerging from crisis.